Guest Contributor: Brenice Duroseau
PhD Candidate at Johns Hopkins University School of Nursing

Nursing, at its core, is a profession built on care—yet care is not neutral. It exists within systems shaped by history, power, and oppression. As nurses, we do not simply provide healthcare; we operate within the legacies of colonialism, white supremacy, and capitalism, all of which dictate who has access to healing and who is denied it. Our power as providers demands responsibility—to disrupt these legacies, to reject complicity, and to work toward justice in both word and action.

Nurses have long been the backbone of healthcare, holding the unique position of being both the most trusted profession and the largest sector of the healthcare workforce. Yet, nursing as a discipline has long struggled with acknowledging the intersectional realities of its workforce and the patients we serve. As Dr. Peggy Chinn discusses in What Does Intersectionality Have to Do with Nursing?, the nursing profession prides itself on a holistic approach to care—yet often fails to fully account for the structural and political forces that drive health disparities. The concept of focusing on the whole person, as described in the blog, reveals a fundamental tension: while nursing aims to see individuals holistically, it often fails to acknowledge how race, gender, and other marginalized identities shape healthcare experiences due to systems of oppression and exclusion. The groundbreaking work of scholars, like Dr. Kimberlé Crenshaw and Dr. Lisa Bowleg, on intersectionality has been instrumental in helping scholars and practitioners understand how systems of power interact to oppress marginalized groups. This tension—between the intent to provide holistic care and the failure to fully recognize the structural forces that shape health inequities—is precisely why nursing must be both a political act and a site of resistance.

Our influence extends far beyond bedside care—we are educators, advocates, policy shapers, and, at times, the last line of defense against systemic failures that disproportionately impact marginalized communities. Today, as we navigate uncertain political times, our role has never been more critical.

A Legacy of Stigma and Resilience

As a Black Haitian-American nurse practitioner and emerging scholar, I have witnessed firsthand how dominant narratives in society and healthcare fail to incorporate the experiences of marginalized communities and continue to perpetuate harm. Throughout my career I have seen firsthand the impact of health inequities, racism, and xenophobia on marginalized communities. The early 1980s saw the emergence of one of the most harmful public health narratives in modern history: the classification of Haitians as a “high-risk group” for HIV. I grew up hearing stories of how Haitians were vilified during the early days of the HIV/AIDS epidemic—accused of bringing the virus to the United States and labeled as “infectious.” This unfounded claim led to widespread discrimination, from travel bans to refusals of medical care. Even today, some Haitians still avoid blood donation and HIV testing, fearing the lingering effects of this prejudice. Fueled by misinformation and racism, this stigma not only cost lives but also deepened mistrust in the healthcare system—damage we are still working to undo. This impact is a stark reminder that public health narratives have lasting consequences, ones that nurses, as frontline providers, must actively work to dismantle. This moment in history calls upon us, as nurses, to leverage our collective power to push for justice-driven healthcare. It is not enough to be the most trusted profession; we must also be among the most courageous.

Nursing as a Political Act

Healthcare does not exist in a vacuum. Policies surrounding immigration, reproductive health, public health funding, and racial justice all have direct implications for our patients and for us as providers. Yet, nursing has often been seen as an apolitical profession—one focused solely on care, not on the structures and systems that dictate who receives care and under what conditions. The failure to integrate intersectionality into nursing theory is not just an academic oversight—it directly contributes to health inequities, poor patient outcomes, and systemic neglect as history has demonstrated.

Nurses have always been at the forefront of social movements, from the civil rights activism of nurse-midwife Maude Callen to the labor organizing of the Chicago Black Nurses Association. Today, we must continue this legacy by confronting the political forces that shape health inequities. As a nurse, I have seen the long shadow of stigma and racism in my clinical practice. Marginalized groups are often reluctant to seek services, citing distrust in a system that once scapegoated and harmed them. For Haitian communities, this is not just historical—it is ongoing. Haitian asylum seekers and migrants continue to face structural barriers to care, from lack of language access to outright medical neglect and exclusion. We recently witnessed the xenophobic rhetoric surrounding the Haitian community in Ohio during recent political discourse, which had a chilling ripple effect nationwide. And for Black women, we still face significant burdens and adverse outcomes within the healthcare system and broader society, as evidenced by disproportionate rates of HIV/STIs, intimate partner violence, maternal mortality, and other structural inequities. Despite overwhelming evidence of our disproportionate vulnerability, HIV prevention efforts, sexual and reproductive healthcare, and policy interventions still fail to center our needs, particularly in priority states and jurisdictions across the United States. We cannot separate health from the policies that govern it. This is why nursing must be a political act.

Nursing as a Site of Resistance and Possibility

I entered nursing because I believe in care as a radical act—but I also know that nursing has never been free from the violence of the systems in which it operates. Nursing, like all institutions, is steeped in histories of exclusion, exploitation, and gatekeeping. It has participated in colonial medicine, eugenics, and the policing of marginalized bodies. It is our responsibility to reckon with these truths—not to deny them, but to confront them, to repair harm, and to imagine something different. This is why representation in nursing matters—not as a checkbox, but as a shift in power. The profession remains disproportionately white, both in leadership and in theoretical discourse. If we are to truly leverage our power as the largest sector in healthcare, we must push for more diverse nurses in leadership, research, and policy roles. We must also actively challenge the theories and frameworks that currently shape nursing knowledge, ensuring that they are inclusive of Black, Indigenous, and other marginalized perspectives.

While Emancipatory Nursing Praxis and Critical Caring theories highlighted by Dr. Chinn provide a foundation, nursing must actively broaden its theoretical base to include Black, Indigenous, and other non-Eurocentric perspectives in nursing praxis. Dr. Lucinda Canty’s Racism in Nursing Model is one such example that critically examines how structural racism impacts nursing practice, workforce development, and patient outcomes. Nurses and scholars with marginalized identities bring urgently needed perspectives that more accurately reflect and address the realities of structural racism, reproductive health inequities, and the systemic power imbalances embedded in healthcare. Our lived experiences—particularly as Black, immigrant, and minority nurses—offer critical insight that can drive meaningful change and reshape the future of healthcare.

The Call to Action: Nurses as Agents of Change

We are at a critical juncture. Political attacks on bodily autonomy, the erosion of public health infrastructure, and the criminalization of migration are all urgent crises demanding a response from health professionals. In these uncertain times, we must ask ourselves: What will be nursing’s legacy? Will we remain complicit in systems that perpetuate inequities, or will we lead the charge in dismantling and rebuilding them? I call on my fellow nurses—whether you are a student, a bedside clinician, a nurse scientist, an educator, or a policymaker—to recognize the political power we hold. Speak up against policies that harm our patients. Challenge institutions that ignore racial and ethnic health disparities. Advocate for the inclusion of marginalized communities in research and policymaking. Question where you stand. Commit to discomfort. Work in solidarity, not charity. And for my fellow nurses with marginalized identities, who may not have the privilege of a social safety net, remember that rest is a form of resistance. It’s okay not to always be at the forefront—our presence alone is an act of resistance. Nurses are not just caregivers—we are architects of change. Our histories, stories, and expertise are invaluable. Let’s ensure that our profession’s legacy is one of justice, equity, and unwavering advocacy.

References

Bowleg, L. (2015). Evolving Intersectionality Within Public Health: From Analysis to Action. American Journal of Public Health 111, 88-90. https://doi.org/10.2105/AJPH.2020.306031

Bowleg, L. (2017). Intersectionality: An Underutilized but Essential Theoretical Framework for Social Psychology. In: Gough, B. (Eds.). The Palgrave Handbook of Critical Social Psychology. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-137-51018-1_25

Canty L, Nyirati C, Taylor V, Chinn PL. An Overdue Reckoning on Racism in Nursing. Am J Nurs. 2022 Feb 1;122(2):26-34. doi: 10.1097/01.NAJ.0000819768.01156.d6. PMID: 35027524.

Crenshaw, K. (1989). Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics. University of Chicago Legal Forum, 1989 (1), Article 8. http://chicagounbound.uchicago.edu/uclf/vol1989/iss1/8

About Brenice Duroseau

Brenice Duroseau, PhD(c), MSN, FNP-C, RNC-OB, AAHIVS, is a Black Haitian-American clinician specializing in infectious diseases and addiction medicine, as well as an emerging nurse scientist in sexual and reproductive health (SRH) equity. Grounded in Black Feminist and Intersectionality theories, her research explores how social, structural, and political determinants shape SRH experiences, engagement, and access for marginalized women across the lifespan. Her work shifts from traditional risk-based models to frameworks centered on wellness, pleasure, and empowerment. Through community-driven research and policy advocacy, Ms. Duroseau is dedicated to dismantling systemic barriers and reimagining equitable, affirming, and holistic healthcare. Bridging clinical practice, research, and mentorship, she is committed to transforming SRH services to prioritize agency, joy, and justice.